Tech tools can fight isle hepatitis

A support network envisions rural clinics that use telemedicine to combat the disease

Alan Tice wants to aggressively battle what has been known as a silent epidemic in Hawaii through the Internet.

Working with the Hepatitis Support Network of Hawaii, Tice wants to open rural clinics for hepatitis treatment in Hawaii using telemedicine, visiting a patient through a Web camera and video screen with the help of a medical assistant. But first the state Legislature must approve the organization's request for a $244,000 grant over two years to launch the program.

"If we had an established program where we could basically bring me or a doctor to them via a video monitor and a cell phone or video monitor and audio system, then we could have a good assessment of the patient. It's bringing health care to the community," said Tice, associate professor at the John A. Burns School of Medicine and an infectious-disease specialist.

About 23,000 people in Hawaii are carriers of the hepatitis virus, but only about 15,000 cases of the disease have been reported, said Heather Lusk, of the state Department of Health.

One of the biggest challenges facing the Department of Health is that a third of those infected do not even know it, she said, adding that early detection of the disease saves lives and money.

There are few symptoms of the hepatitis virus for 20 to 30 years until the disease progresses into liver cancer or cirrhosis of the liver. By then, treatment for the disease is greatly reduced.

It is like a silent epidemic in Hawaii, which has the highest rate of liver cancer in the nation, Lusk said. For the first time, doctors might have a cure for the virus, making early detection more powerful today, she said.

Hepatitis C can be transferred through sharing needles or razors or through open wounds. Thousands who received blood transfusions before 1992, when a test for the virus was first created, were infected and might not know it, Lusk said. Hepatitis B is transferred mother to child and can be brought from Asian populations, where there are higher rates of hepatitis, to Hawaii.

The Hepatitis Support Network of Hawaii hopes it will be able to help the battle in Hawaii's rural areas, where there are fewer doctors and possibly more carriers of the disease among homeless or immigrants. Organizers say they plan to focus on educating people about testing, help them get tested and help with treatments.

"Treatment is not easy and takes up to a year sometimes to treat people and to get rid of the virus," Tice said. "But the opposite expense is for these people to come in with liver cancer and liver failure. It's terribly expensive there, too."

Treatment can entail monthly visits to a medical aide, addressing side effects of the drugs and refrigerating the medicine. The telemedicine clinic can do all those as well as help people who are hard to reach because they might be homeless, Tice said.

Tice is already helping with hepatitis treatments at five locations on Oahu. But if the state Legislature grants the network the money, the organization will start two telemedicine sites, on the North Shore and in Hilo, and possibly on Molokai, Maui and Kauai.

"It's a way to bring medical care to the needy or the homeless or those that are reluctant to expose themselves as far having this disease," Tice said.